Elekta SL25 Research Articles

Characterization of a Modified Clinical Linear Accelerator for Ultra-High Dose Rate Beam Delivery

Irradiations at Ultra-High Dose Rate (UHDR) regimes, exceeding 40 Gy/s in single fractions lasting less than 200 ms, have shown an equivalent antitumor effect compared to conventional radiotherapy with reduced harm to normal tissues. This work details the hardware and software modifications implemented to deliver 10 MeV UHDR electron beams with a linear accelerator Elekta SL 18 MV and the beam characteristics obtained. GafChromic EBT XD films and an Advanced Markus chamber were used for dosimetry characterization, while a silicon sensor assessed the machine’s beam pulses stability and repeatability. The dose per pulse, average dose rate and instantaneous dose rate in the pulse were evaluated for four experimental settings, varying the source-to-surface distance and the beam collimation, i.e., with and without the use of a cylindrical applicator. The results showed a dose per pulse from 0.6 Gy to a few tens of Gy and an average dose rate up to 300 Gy/s. The obtained results demonstrate the possibility to perform in vitro radiobiology experiments and test new technologies for beam monitoring and dosimetry at the upgraded LINAC, thus contributing to the electron UHDR research field.

Phantom dosimetry and cancer risks estimation undergoing 6 MV photon beam by an Elekta SL-25 linac

The High-energy linear accelerator (linac) is a valuable tool and the most commonly used devices for external beam radiation treatments in subjects suffer from cancer. To estimate the dose deposited in several organs of a female patient due to pelvic irradiation by an Elekta SL-25 linac in 6 MV photon beam mode, the MCNPX code is used considering the most details of linac. The equivalent dose in different organs is computed according to the face down position (prone) of MIRD and UFRO phantoms. The data obtained using MCNPX show that the received dose in all commons organs of MIRD and UFRO phantoms is 535.73 and 433.09 mSv/Gyx, respectively. The risks of second cancer incidence and mortality during radiotherapy treatment are compared between MIRD and UFRO phantoms. The results indicated that bladder has the maximum risk of secondary cancer incidence risk of 142.85 and 135.34 per 105 persons based on MIRD and UFRO phantoms, respectively; while the total risk is about 1 in 163 and about 1 in 101 in these phantoms.

Characterization of Nylon-12 as a water-equivalent solid phantom material for dosimetric measurements in therapeutic photon and electron beams

The tissue- or water-equivalence of dosimetry phantoms used as substitutes for water is essential for absorbed dose measurements in radiotherapy. At our institution, a heterogeneous pelvic phantom that consists of stacked Nylon-12 layers has recently been manufactured for Gafchromic film dosimetry. However, data on the use of Nylon as tissue-mimicking media for dosimetric applications are scarce. This study characterizes the water-equivalence of Nylon-12 for dosimetric measurements in therapeutic photon and electron beams. Employing an Elekta Synergy and SL25 linear accelerator (Linac), photon beam transmission measurements for 6 MV and 15 MV, acquired in narrow beam geometry with a 0.6 cm3 Farmer-type ion chamber showed that the mass attenuation coefficient μm of Nylon-12 agrees with the values of water, water-equivalent RW3 and Perspex phantom materials within 3%. For 6 MV, the μm values were 0.0477 ± 0.002 cm2/g, 0.0490 ± 0.003 cm2/g, 0.0482 ± 0.001 cm2/g and 0.0479 ± 0.002cm2/g for Nylon-12, water, RW3, and Perspex, respectively. Differences within 2% were attained between depth dose data measured in Nylon-12 slabs with Gafchromic EBT3 films and in water with a Roos ion chamber for 10 × 10 cm2 6, 12 and 20 MeV electron beams produced by the Elekta Synergy and SL25 Linacs. Also, a good agreement within 2% was obtained between percent depth doses computed by DOSXYZnrc Monte Carlo simulations in water, Nylon-12 and RW3 materials for photon spectra between 250 kV and 15 MV. The discrepancies between the ratios of average, restricted stopping powers of Nylon to air and water to air for photon spectra ranging from 2 to 45 MV are typically within 1% signifying that Nylon and water have equivalent stopping power characteristics. This study highlights that Nylon-12 can be used as a tissue-mimicking phantom material for dosimetric measurements in clinical megavoltage photon and electron beams as it exhibits good water-equivalence.

The Influence of Brass Compensator Thickness and Field Size on Neutron Contamination Spectrum in 18MV Elekta SL 75/25 Medical Linear Accelerator with and without Flattening Filter: A Monte Carlo Study

One of the most significant Intensity Modulated Radiation Therapy treatment benefits is a high target to normal tissue dose ratio. To improve this advantage, an additional accessory such as a compensator is used to deliver doses. Compensator-based IMRT treatment is usually operated with an energy higher than 10 MV. Photoneutrons, which have high linear energy transfer and radiobiological effectiveness, are produced by colliding high-energy photon beams with linear accelerator structures, then they deliver the unwanted doses to patients and staff. Therefore, the neutron energy spectra should be determined in order to calculate and reduce the photoneutron risk. We have conducted a comprehensive and precise study on the influence of brass compensator thickness and field size on neutron contamination spectrum in an Elekta SL 75/25 medical linear accelerator with and without the flattening filter by Monte Carlo method. MCNPX MC Code version 2.6.0 was utilized to simulate the detailed geometry of Elekta SL 75/25 head components based on Linac's manual. This code includes an important feature to simulate the photo-neutron interactions. Photoneutrons spectrum was calculated after the Linac output benchmarking based on tuning the primary electron beam. Based on the Friedman and Wilcoxon nonparametric tests results (P<0.05), photoneutron fluence directly depends on the field size and compensator thickness. Moreover, the unflattened beam provides lower photoneutron fluence than the flattened beam. Photoneutrons fluence is not negligible in compensator-based IMRT treatment. However, in order to optimize treatment plans, this additional and unwanted dose must be accounted for patientss.

PHITS simulations of absorbed dose out-of-field and neutron energy spectra for ELEKTA SL25 medical linear accelerator

Monte Carlo (MC) based calculation methods for modeling photon and particle transport, have several potential applications in radiotherapy. An essential requirement for successful radiation therapy is that the discrepancies between dose distributions calculated at the treatment planning stage and those delivered to the patient are minimized. It is also essential to minimize the dose to radiosensitive and critical organs. With MC technique, the dose distributions from both the primary and scattered photons can be calculated. The out-of-field radiation doses are of particular concern when high energy photons are used, since then neutrons are produced both in the accelerator head and inside the patients. Using MC technique, the created photons and particles can be followed and the transport and energy deposition in all the tissues of the patient can be estimated. This is of great importance during pediatric treatments when minimizing the risk for normal healthy tissue, e.g. secondary cancer. The purpose of this work was to evaluate 3D general purpose PHITS MC code efficiency as an alternative approach for photon beam specification. In this study, we developed a model of an ELEKTA SL25 accelerator and used the transport code PHITS for calculating the total absorbed dose and the neutron energy spectra infield and outside the treatment field. This model was validated against measurements performed with bubble detector spectrometers and Boner sphere for 18 MV linacs, including both photons and neutrons. The average absolute difference between the calculated and measured absorbed dose for the out-of-field region was around 11%. Taking into account a simplification for simulated geometry, which does not include any potential scattering materials around, the obtained result is very satisfactorily. A good agreement between the simulated and measured neutron energy spectra was observed while comparing to data found in the literature.

TH-CD-304-08: Small Air-Gaps Affect the Response of Ionization Chambers in the Presence of a 1.5 T Magnetic Field

Purpose: Small air-gaps surrounding ionization chambers (ICs) are unavoidable if ICs are used in plastic phantoms. Here we show that air-gaps affect the response of ICs in a 1.5 T magnetic (B-)field from a MR-linac. Methods: We used NE2571 and PTW30013 Farmer chambers with and without a 1.5 T B-field for measurements and Monte Carlo simulations. For measurements, the chambers were exposed in water-equivalent plastic and water phantoms at the University Medical Center Utrecht in a 1.5 T MR-linac and an Elekta Precise linac. The NE2571 Farmer chamber was modeled with Geant4 at a 10 cm depth in a water phantom with a 1.5 T B-field with a beam modeled from a 10×10 cm2 Elekta SL25 6 MV energy spectrum. The detector model was positioned on the central-axis with a cylindrical air block surrounding it (symmetric) or beside it (asymmetric). The chamber cavity dose was calculated for a range of air-gap thicknesses. Chamber, beam and B-field were all orthogonal. Results: To experimentally change the distribution of air-gaps surrounding the chamber in the plastic phantom we rotated the chamber about its cylindrical axis. Variations of 1.8% and 1.3% were observed in the response of the NE2571 and PTW30013 ICs, respectively, in the presence of a B-field. No effect was observed when it was exposed in water instead of plastic or in plastic but without the B-field. The symmetric simulations show that the chamber cavity dose decreases as the air-gap thickness increases. The effect is >1% for thicknesses >1 mm. For a 0.25 mm asymmetric air-gap the dose-response varied by up to 2.2% depending on air-gap orientation. These effects disappear when no B-field is modeled. Conclusion: Small air-gaps surrounding a Farmer chamber may affect its response by over 1% when the chamber is exposed in the presence of a 1.5 T B-field. Funding provided by Elekta Limited.

TU-F-CAMPUS-T-01: Calculation of KQ for a Variety of Commercially Available Ionization Chambers in the Presence of An External Magnetic Field for MR-Linac Dosimetry

Purpose: The strong magnetic fields associated with MRI have a significant impact on the dosimetry of radiotherapy beams as well as on the response of the detectors used to measure it. In order to calibrate the dose delivered by these beams, it is necessary to correct for these effects when performing measurements with ionization chambers. Methods: Detailed models of 16 commercially-available ionization chambers were implemented in Geant4. To validate these models, calculations of the beam quality correction factor kQ (defined by TG-51) were performed using the spectrum from a 6 MV Elekta SL25. kQ values were then recalculated for each detector with a 1.5 T external magnetic field applied uniformly across the geometry. Chamber, beam and B-field were all orthogonal. Results: The comparison between the kQ calculations and TG-51 showed agreement within 1.4%. The B-field calculations indicate that the change in kQ values due to the B-field is strongly affected by the volume and material of the ionization chamber. All large volume (>0.5 cm 3) ionization chambers had lower kQ values when used in a B-field. The kQ values for small volume chambers were very sensitive to the chambers’ collecting volume and could be higher or lower when used in a B-field. Conclusions: Of the chambers tested, the PTW 30011 demonstrated the smallest correction of just 1.2%. The next step is to calculate kQ using the energy spectrum from an actual MR-linac. Further validation of these results against measurements will be paramount before they can be used. Funding provided by Elekta Limited. The MR-linac spectrum will be provided by Elekta Limited based on a machine they have designed.

SU-D-BRF-01: Applications of Photonuclear Activation of Biological Tissues in Clinical High-Energy X-Ray Beams

Purpose: The commercial availability of high-energy accelerators opens new therapeutic opportunities for X-rays with energies in excess of 15MV. Three clinical beams (Varian 18MV, Elekta SL25, and Top Grade LA45) were compared by the production of photo-activated positron emitters in five types of biological tissues. Methods: The activation studies were performed using FLUKA2011 Monte Carlo suite with beam models designed for the three accelerators. Absolute activity density (Bq/ml) distribution in space was obtained from this study. Additionally, the temporal evolution of all activated species was monitored for cooling times up to 30 minutes. Results: The relative activation contrast of tissue pairs was evaluated for 2Gy of dose at 10cm depth for five tissues (normal, hypoxic, adipose, bone, and lung). In bone the sort-lived isotopes O-15 and P-30 dominated the activity at the early cooling stages. In all tissues 15 minutes post-irradiation the C-11 activity became dominant. Tissues with higher carbon-to-oxygen ratio in their elemental composition became clearly visible in a PET scan at longer cooling times. Radiation treatment of a lung tumor with a hypoxic core was simulated in an anthropomorphic phantom using the LA45 beam model. Increase in the PET counts by more than 50% was measured in the hypoxic volume 15 minutes post-irradiation, demonstrating the benefits of the relative activation contrast concept. Conclusion: LA45 beam is found to produce measurable activation distribution for 2Gy of dose, suitable for tissue type discrimination studies. Maximum activation contrast of 1.7 between hypoxic and normal tissues was measured in a simulated treatment. The absolute activity density values obtained from these Monte Carlo studies suggest that the window of opportunity for a PET scan exists up to 60 minutes after 2Gy of dose is deposited by 45MV X-ray beam. Lung-to-tissue activation contrast can be explored for treatment QA purposes as well.

Feasibility study of patient positioning verification in electron beam radiotherapy with an electronic portal imaging device (EPID)

The purpose of this study is to demonstrate the feasibility of verification and documentation in electron beam radiotherapy using the photon contamination detected with an electronic portal imaging device. For investigation of electron beam verification with an EPID, the portal images are acquired irradiating two different tissue equivalent phantoms at different electron energies. Measurements were performed on an Elekta SL 25 linear accelerator with an amorphous-Si electronic portal imaging device (EPID: iViewGT™, Elekta Oncology Systems, Crawley, UK). As a measure of EPID image quality contrast (CR) and signal-to-noise ratio (SNR) are determined. For characterisation of the imaging of the EPID RW3 slabs and a Gammex 467 phantom with different material inserts are used. With increasing electron energy the intensity of photon contamination increases, yielding an increasing signal-to-noise ratio, but images are showing a decreasing contrast. As the signal-to-noise ratio saturates with increasing dose a minimum of 50 MUs is recommended. Even image quality depends on electron energy and diameter of the patient, the acquired results are mostly sufficient to assess the accuracy of beam positioning. In general, the online EPID acquisition has been demonstrated to be an effective electron beam verification and documentation method. The results are showing that this procedure can be recommended to be routinely and reliably done in patient treatment with electron beams.

Extraction of electron beam dose parameters from EBT2 film data scored in a mini phantom

Quality assurance of medical linear accelerators includes dosimetric parameter measurement of therapeutic electron beams e.g. relative dose at a depth of 80% (R₈₀). This parameter must be within a tolerance of 0.2 cm of the declared value. Cumbersome water tank measurements can be regarded as a benchmark to measure electron depth dose curves. A mini-phantom was designed and built, in which a strip of GAFCHROMIC® EBT2 film could be encased tightly for electron beam depth dose measurement. Depth dose data were measured for an ELEKTA Sl25 MLC, ELEKTA Precise, and ELEKTA Synergy (Elekta Oncology Systems, Crawley, UK) machines. The electron beam energy range was between 4 and 22 MeV among the machines. A 10 × 10 cm² electron applicator with 95 cm source-surface-distance was used on all the machines. 24 h after irradiation, the EBT2 film strips were scanned on Canon CanoScan N670U scanner. Afterwards, the data were analysed with in-house developed software that entailed optical density to dose conversion, and optimal fitting of the PDD data to de-noise the raw data. From the PDD data R₈₀ values were solved for and compared with acceptance values. A series of tests were also carried out to validate the use of the scanner for film Dosimetry. These tests are presented in this study. It was found that this method of R₈₀ evaluation was reliable with good agreement with benchmark water tank measurements using a commercial parallel plate ionization chamber as the radiation detector. The EBT2 film data yielded R₈₀ values that were on average 0.06 cm different from benchmark water tank measured R₈₀ values.

Evaluation of Gafchromic® EBT3 films characteristics in therapy photon, electron and proton beams

PurposeTo evaluate the uncertainties and characteristics of radiochromic film-based dosimetry system using the EBT3 model Gafchromic® film in therapy photon, electron and proton beams. Material and methodsEBT3 films were read using an EPSON Expression 10000XL/PRO scanner. They were irradiated in five beams, an Elekta SL25 6 MV and 18 MV photon beam, an IBA 100 MeV 5 × 5 cm2 proton beam delivered by pencil-beam scanning, a 60 MeV fixed proton beam and an Elekta SL25 6 MeV electron beam. Reference dosimetry was performed using a FC65-G chamber (Elekta beam), a PPC05 (IBA beam) and both Markus 1916 and PPC40 Roos ion-chambers (60 MeV proton beam). Calibration curves of the radiochromic film dosimetry system were acquired and compared within a dose range of 0.4–10 Gy. An uncertainty budget was estimated on films irradiated by Elekta SL25 by measuring intra-film and inter-film reproducibility and uniformity; scanner uniformity and reproducibility; room light and film reading delay influences. ResultsThe global uncertainty on acquired optical densities was within 0.55% and could be reduced to 0.1% by placing films consistently at the center of the scanner. For all beam types, the calibration curves are within uncertainties of measured dose and optical densities. The total uncertainties on calibration curve due to film reading and fitting were within 1.5% for photon and proton beams. For electrons, the uncertainty was within 2% for dose superior to 0.8 Gy. ConclusionsThe low combined uncertainty observed and low beam and energy-dependence make EBT3 suitable for dosimetry in various applications.

SU-E-T-118: Characterization of EBT3 Films in Photon and Proton Beams.

To measure the calibration curves of EBT3 dosimetry films in photon and proton beams and to quantify the related uncertainties from one beam type to another. EBT3 Gafchromic films have similar properties than EBT2 with a symmetric construction and a matte polyester substrate to prevent Newton's ring artefacts. Films from a same batch were exposed in three different beam qualities, an Elekta SL25 6 MV photon beam, a 100 MeV 5×5cm2 proton beam delivered by pencil-beam scanning dedicated system from IBA and a 60 MeV fixed proton beam (2.5cm in diameter) at Clatterbridge Center for Oncology (CCO), UK. The films were read using an EPSON 10000 XL/PRO scanner. Film calibration curves were acquired for all modalities within a range of 0.05 to 20 Gy. Influence of increasing linear-energy transfer (LET) on film response was investigated by comparing dose measured by EBT3 to a silicon diode detector in depth for a fully-modulated beam using the CCO beam line (homogeneous dose with distal end at 3.1cm in water). A comprehensive uncertainty budget (reproducibility, uniformity'¦) was estimated on films irradiated by Elekta SL25. The main source of uncertainty was the non-uniformity of the scanner response. By placing all the irradiated films at the center of the scanner, the uncertainty could be reduced from 5.8% to 1.9% (1 sigma). For all beams and energies, the calibration curves were matched within uncertainties. Along the fully-modulated depth dose curve, diode and EBT3 measurement were in a 4% agreement point-to-point, indicating films weak dependence with LET. The weak influence of LET, beam type and energy on film response as well as its small uncertainty make EBT3 suitable for relative dosimetry and a promising candidate for measuring correction factors (quality, recombination,'¦) for reference dosimetry with ion chambers of non-standard beams (e.g pencil-beam scanning proton-therapy). “This work is supported by the Walloon Region under the project name InVivoIGT, convention number 1017266.â€.

SU-E-T-420: Development of a Comprehensive Linac-Based Quality Assurance Procedure for Retrofitted Micro-MLC SRS System.

To develop a QA tool and methodology to be used with an Elekta SL 25 Linear Accelerator retrofitted with a 3DLine Micro-MLC gantry attachment in a room installed with the 3DLine Dynatrac camera localization system Methods: A phantom wa manufactured from clear polyester casting resign. This phantom was designed to fit within the localizing head frame to test the accuracy of the 3DLine camera system in terms of isocenter localization. The phantom was aligned using the imported isocenter coordinates from the ERGO++ TPS. The phantom consists of metallic wires intersecting at the center and extending outwards to the center of each of the six sides of the cube. Gafchromic film was taped to each side and the cube was irradiated at different gantry and couch angles to verify isocenter accuracy to within 1mm in accordance with TG 142. The films were analyzed with RIT113 software, using the 50% isodose curves as the field edges and the center of the field as marked by each of the wiresextending outwards from the isocenter. Prelimina ry results of this isocenter test with the retrofitted Micro-MLC gantry head attachment show a deviation of .72mm and -1.25 in the × and y directions respectively for the 90° gantry angle. A deviation of -1.27mm and -2.35mm in the x and y directions, respectively were measured for the 270° gantry angle. The additional sides will be irradiated and their results along the results of the additional tests will be presented at the AAPM national conference. After successful completion of the above procedures for SRS QA, it was determined that the phantom made with the localization wires can indeed be used to accurately and efficiently QA a linac-based SRS system for isocenter location accuracy.

A combined approach of variance-reduction techniques for the efficient Monte Carlo simulation of linacs

A method based on a combination of the variance-reduction techniques of particle splitting and Russian roulette is presented. This method improves the efficiency of radiation transport through linear accelerator geometries simulated with the Monte Carlo method. The method named as ‘splitting-roulette’ was implemented on the Monte Carlo code and tested on an Elekta linac, although it is general enough to be implemented on any other general-purpose Monte Carlo radiation transport code and linac geometry. Splitting-roulette uses any of the following two modes of splitting: simple splitting and ‘selective splitting’. Selective splitting is a new splitting mode based on the angular distribution of bremsstrahlung photons implemented in the Monte Carlo code . Splitting-roulette improves the simulation efficiency of an Elekta SL25 linac by a factor of 45.

Neutron dose equivalent and neutron spectra in tissue for clinical linacs operating at 15, 18 and 20 MV

In this work, the dose equivalent due to photoneutrons and the neutron spectra in tissue was calculated for various linacs (Varian Clinac 2100C, Elekta Inor, Elekta SL25 and Siemens Mevatron KDS) operating at energies between 15 and 20 MV, using the Monte Carlo code MCNPX (v. 2.5). The dose equivalent in an ICRU tissue phantom has been calculated for anteroposterior treatments with a detailed simulation of the geometry of the linac head and the coupled electron-photon-neutron transport. Neutron spectra at the phantom entrance and at 1-cm depth in the phantom, depth distribution of the neutron fluence in the beam axis and dose distributions outside the beam axis at various depths have also been calculated and compared with previously published results. The differences between the neutron production of the various linacs considered has been analysed. Varian linacs show a larger neutron production than the Elekta and Siemens linacs at the same operating energy. The dose equivalent due to neutrons produced by medical linacs operating at energies >15 MeV is relevant and should not be neglected because of the additional doses that patients can receive.

Dose to medium versus dose to water as an estimator of dose to sensitive skeletal tissue

The purpose of this study is to determine whether dose to medium, Dm, or dose to water, Dw, provides a better estimate of the dose to the radiosensitive red bone marrow (RBM) and bone surface cells (BSC) in spongiosa, or cancellous bone. This is addressed in the larger context of the ongoing debate over whether Dm or Dw should be specified in Monte Carlo calculated radiotherapy treatment plans. The study uses voxelized, virtual human phantoms, FAX06/MAX06 (female/male), incorporated into an EGSnrc Monte Carlo code to perform Monte Carlo dose calculations during simulated irradiation by a 6 MV photon beam from an Elekta SL25 accelerator. Head and neck, chest and pelvis irradiations are studied. FAX06/MAX06 include precise modelling of spongiosa based on µCT images, allowing dose to RBM and BSC to be resolved from the dose to bone. Modifications to the FAX06/MAX06 user codes are required to score Dw and Dm in spongiosa. Dose uncertainties of ∼1% (BSC, RBM) or ∼0.5% (Dm, Dw) are obtained after up to 5 days of simulations on 88 CPUs. Clinically significant differences (>5%) between Dm and Dw are found only in cranial spongiosa, where the volume fraction of trabecular bone (TBVF) is high (55%). However, for spongiosa locations where there is any significant difference between Dm and Dw, comparisons of differential dose volume histograms (DVHs) and average doses show that Dw provides a better overall estimate of dose to RBM and BSC. For example, in cranial spongiosa the average Dm underestimates the average dose to sensitive tissue by at least 5%, while average Dw is within ∼1% of the average dose to sensitive tissue. Thus, it is better to specify Dw than Dm in Monte Carlo treatment plans, since Dw provides a better estimate of dose to sensitive tissue in bone, the only location where the difference is likely to be clinically significant.

Evaluation of a commercial VMC++ Monte Carlo based treatment planning system for electron beams using EGSnrc/BEAMnrc simulations and measurements

In the present work, Monte Carlo (MC) models of electron beams (energies 4, 12 and 18 MeV) from an Elekta SL25 medical linear accelerator were simulated using EGSnrc/BEAMnrc user code. The calculated dose distributions were benchmarked by comparison with measurements made in a water phantom for a wide range of open field sizes and insert combinations, at a single source-to-surface distance (SSD) of 100 cm. These BEAMnrc models were used to evaluate the accuracy of a commercial MC dose calculation engine for electron beam treatment planning (Oncentra MasterPlan Treament Planning System (OMTPS) version 1.4, Nucletron) for two energies, 4 and 12 MeV. Output factors were furthermore measured in the water phantom and compared to BEAMnrc and OMTPS. The overall agreement between predicted and measured output factors was comparable for both BEAMnrc and OMTPS, except for a few asymmetric and/or small insert cutouts, where larger deviations between measurements and the values predicted from BEAMnrc as well as OMTPS computations were recorded. However, in the heterogeneous phantom, differences between BEAMnrc and measurements ranged from 0.5 to 2.0% between two ribs and 0.6–1.0% below the ribs, whereas the range difference between OMTPS and measurements was the same (0.5–4.0%) in both areas. With respect to output factors, the overall agreement between BEAMnrc and measurements was usually within 1.0% whereas differences up to nearly 3.0% were observed for OMTPS. This paper focuses on a comparison for clinical cases, including the effects of electron beam attenuations in a heterogeneous phantom. It, therefore, complements previously reported data (only based on measurements) in one other paper on commissioning of the VMC++ dose calculation engine. These results demonstrate that the VMC++ algorithm is more robust in predicting dose distribution than Pencil beam based algorithms for the electron beams investigated.

A Monte Carlo study on neutron and electron contamination of an unflattened 18-MV photon beam

Recent studies on flattening filter (FF) free beams have shown increased dose rate and less out-of-field dose for unflattened photon beams. On the other hand, changes in contamination electrons and neutron spectra produced through photon ( E>10 MV) interactions with linac components have not been completely studied for FF free beams. The objective of this study was to investigate the effect of removing FF on contamination electron and neutron spectra for an 18-MV photon beam using Monte Carlo (MC) method. The 18-MV photon beam of Elekta SL-25 linac was simulated using MCNPX MC code. The photon, electron and neutron spectra at a distance of 100 cm from target and on the central axis of beam were scored for 10×10 and 30×30 cm 2 fields. Our results showed increase in contamination electron fluence (normalized to photon fluence) up to 1.6 times for FF free beam, which causes more skin dose for patients. Neuron fluence reduction of 54% was observed for unflattened beams. Our study confirmed the previous measurement results, which showed neutron dose reduction for unflattened beams. This feature can lead to less neutron dose for patients treated with unflattened high-energy photon beams.

Monte Carlo study on a flattening filter-free 18-MV photon beam of a medical linear accelerator

Several studies on the dosimetric properties of unflattened photon beams have shown some advantages for radiotherapy. In this study, the effect of removing the flattening filter from an 18-MV photon beam was investigated using the Monte Carlo method. The 18-MV photon beam of an Elekta SL25 linear accelerator was simulated using the MCNP4C Monte Carlo (MC) code. Beam dosimetric features, including central axis absorbed doses, beam profiles, and photon energy spectra, were calculated for flattened and unflattened 18-MV photon beams. A 4.24-fold increase in the dose rate was seen for the unflattened beam with a field size of 10 x 10 cm(2). A decrease in the out-of-field dose up to 30% was seen for the unflattened beam. For the unflattened beam, photon energy spectra were softer, and the mean energies of the spectra were higher for a smaller field size. Our study showed that the increase in dose rate and lower out-of-field dose can be possible advantages for an unflattened 18-MV beam.

SU-GG-T-371: Monte Carlo Neutron Shielding Evaluation of Treatment Vaults Built to NCRP 49 Or NCRP 151 Recommendations

Purpose: To use MCNP5 to compare and contrast the recommendations found in NCRP 49 and NCRP 151 pertaining to neutron shielding. Method and Materials: An Elekta SL25 accelerator head with nominal peak energy of 18MV was modeled in MCNP5 and verified against known measured beam characteristics.Neutron angular and energy distributions produced by the Elekta SL25 were calculated using the photoneutron production feature of MCNP5. These neutron distributions were then used as source terms for shielding calculations in simulated treatment vaults designed to either NCRP 49 or NCRP 151 standards. Results: The neutron penetration calculations indicate that shielding for megavoltage teletherapy units, i.e. those with energies greater than 10MV, should include materials designed to prevent neutron leakage. A quantitative assessment of neutron dose contributions to personnel outside of the treatment vaults will be presented. Conclusion: Although the phenomenon of photoneutron production has been well known for some time recommendations for shielding these neutrons in megavoltage teletherapy settings are relatively recent. This study may be used by those institutions considering upgrading existing units to ones with higher energies or by new sites to justify the added expense of incorporating shielding aimed at preventing neutron leakage.